ABSTRACT This mixed-methods study utilizes a dynamic combination of large secondary data sets and qualitative data collection, to garner a sophisticated understanding of the relationships between Religion and Spirituality (R/S) and Cardiovascular Disease (CVD) risk factors. CVD risk factors, especially high blood pressure, obesity, diabetes and depression, disproportionately affect African Americans in prevalence and/or severity, contributing to the higher associated mortality rate. Further, examining lifestyle choices (for example, diet and exercise) without appropriate sociocultural context does not provide practice-ready solutions on the manifestations, root causes and potential strategies for eliminating African American?s heightened CVD risks. As such, religion and spirituality (R/S) in the African American community have been acknowledged for their positive influence on social behaviors and emotional health, but have not been sufficiently examined for their role in attenuating or exacerbating physical health outcomes and in particular, the risks associated with CVD. Most research has compared the relationship between R/S and health outcomes by examining the specific denominations of their White participants, and blanketed Black participants? religion to the ?Black Church.? This approach disregards the diversity of beliefs, behaviors and ways of thinking found in the religious affiliation and denominations of African Americans. In a rare project that examined Black health outcomes in relation to specific religious affiliation/denomination, it was revealed that religious attendance had an inverse relationship based upon religious affiliation/denomination on black mortality rates not found in white participants. Thus, the standard of relying on religious affiliation and health studies based on White participants to determine expected outcomes for Black participants is likely to cause inaccuracies in research and interventions. The overarching goals of this research are to investigate the extent to which R/S is related to CVD risk factors (obesity, diabetes, hypertension and depression) through the use of robust secondary and primary data analysis. The two project Aims will use theoretically-, research- and data-driven evidence to bolster efforts to decrease CVD risk factors and improve health outcomes for African Americans. Aim 1 utilizes structural equational modeling to determine if R/S has direct and indirect effects on CVD risk factors through health behaviors. Aim 2 establishes how the relationships manifest through first-hand accounts of the attributes of specific denominations on the health outcomes of its congregants, thus allowing participants to explain how the relationships found in Aim 1 are manifested-or not, in their daily and R/S life. The purpose of this research project is to not only identify the direct and indirect relationships between CVD risk factors and R/S, but to provide in depth knowledge of core attitudes, beliefs, organizational structures, and/or practices that facilitate or attenuate positive health outcomes for African Americans. The precision and nuance of our project?s strategies will fill in significant gaps in research and practice that can be a catalyst for evidence-based interventions that examines of community and religious institutions to support positive health outcomes for African American.